Outcomes/Effectiveness Research

Some patients hospitalized for stroke more likely to keep taking drugs to prevent another stroke

Each year, there are 180,000 recurrent strokes in the United States. Patients who have been hospitalized for stroke are more likely to keep taking medicine to prevent another stroke after hospital discharge depending on their knowledge of the medications, self-reported quality of life, and access to health insurance, according to a new study. The researchers found that three-fourths of 2,598 patients hospitalized for stroke were still taking medicines to prevent future strokes (antiplatelet therapies, warfarin, blood pressure medications, lipid-lowering medications, diabetes medications) 3 months after hospital discharge. The remaining patients or their proxies reported discontinuance of one or more of their prescribed preventive medications during the 3-month period.

Patients who responded for themselves were 71 percent more likely to persist with the preventive drugs. Those with no history of atrial fibrillation were 48 percent more likely to persist at 3 months (although warfarin persistence was 170 percent higher in patients who had had fibrillation). Patients who reported having insurance that covered medications (87.6 percent) were more likely to continue taking their medications. Other factors linked to persistent medication taking included fewer number of medications prescribed, older age, less disability from the original stroke, working status, understanding why the medications were prescribed and how to refill them, and hospital size and geographic location.

The researchers recruited 3,068 potential patients during acute stroke hospitalization at 106 hospitals participating in the nationwide Get With The Guidelines Stroke Program. The final group included 2,598 patients or their proxies. Data analysis for the study was funded in part by the Agency for Healthcare Research and Quality (HS16964).

More details are in "Persistence with stroke prevention medications 3 months after hospitalization," by Cheryl D. Bushnell, M.D., M.H.S., Louise O. Zimmer, M.A., M.P.H., Wenqin Pan, Ph.D., and others in the December 2010 Archives of Neurology 67(12); pp. 1456-1463.

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